Revenue Cycle Specialist

Revenue Cycle Specialist 995 Robert Boulevard, Slidell, LA 70458 Full-time Full-time Position Summary Sterling Surgical Hospital is seeking a detail-oriented and motivated Revenue Cycle Specialist to join our growing Business Office team. This position plays a vital role in maximizing revenue, improving cash flow, and ensuring an exceptional financial experience for our patients. The Revenue Cycle Specialist is responsible for managing various aspects of the revenue cycle, including insurance verification, patient financial counseling, upfront collections, payment arrangements, claim follow-up, denial resolution, account reconciliation, and patient account support. The ideal candidate will possess strong analytical skills, excellent customer service abilities, and a thorough understanding of healthcare billing and reimbursement processes. Essential Duties & Responsibilities Patient Financial Service s Verify insurance benefits, deductibles, coinsurance, copayments, and out-of-pocket responsibilities. Contact patients following their procedures regarding financial responsibility. Establish and monitor patient payment plans. Educate patients on financial policies and available payment options. Respond to patient billing inquiries professionally and timely. Revenue Cycle Management Review accounts receivable and work assigned account follow-up queues. Investigate and resolve denied, rejected, and underpaid claims. Submit claim corrections, appeals, and supporting documentation as needed. Monitor aging reports and prioritize accounts for resolution. Identify reimbursement trends and report issues affecting revenue. Insurance & Claims Processing Verify insurance eligibility and benefits. Obtain authorizations as required. Review explanation of benefits (EOBs) and remittance advice. Ensure claims are billed accurately and timely. Follow payer-specific guidelines and requirements. Payment Processing & Reconciliation Post payments and adjustments accurately. Reconcile patient accounts and identify discrepancies. Assist with month-end revenue cycle reporting and analysis. Collaboration & Process Improvement Work closely with Registration, Scheduling, Medical Records, Clinical Staff, and Providers to ensure accurate patient information and timely claim submission. Assist in identifying workflow improvements that enhance collections and reduce denials. Participate in departmental meetings, training sessions, and special projects. Maintain compliance with hospital policies, HIPAA regulations, and payer requirements. Experience Minimum of 2 years of healthcare revenue cycle, medical billing, collections, insurance verification, or patient financial services experience preferred. Surgical hospital, ASC, or hospital billing experience strongly preferred. Experience with Medicare, Medicaid, Commercial Insurance, Workers' Compensation, and Attorney Accounts preferred. Knowledge, Skills & Abilities Strong understanding of healthcare revenue cycle processes. Knowledge of medical terminology, CPT, HCPCS, and ICD coding principles preferred. Ability to interpret EOBs and insurance reimbursement methodologies. Excellent customer service and communication skills. Strong organizational and problem-solving abilities. Proficiency in Microsoft Office, especially Excel. Ability to manage multiple priorities in a fast-paced environment. High level of professionalism, accuracy, and attention to detail. Physical Requirements Ability to sit for extended periods. Frequent use of computers, telephones, and office equipment. Occasional lifting of up to 20 pounds. Why Join Sterling Surgical Hospital? Competitive compensation Paid Time Off (PTO) Health, Dental, and Vision Insurance Professional Growth & Development Collaborative Team Environment Opportunity to make a meaningful impact on patient care and hospital success Sterling Surgical Hospital is an Equal Opportunity Employer and values excellence, accountability, teamwork, and exceptional patient service.

Benefits:

401(k) 401(k) matching Dental insurance Health insurance Life insurance Paid time off Retirement plan Vision insurance

Work Location:

In person